Figure 2. Patients With Naturally Occurring Plague

A, Cervical bubo in patient with bubonic plague; B, petechial and ecchymotic bleeding into the skin in patient with septicemic plague; and C, gangrene of the digits during the recovery phase of illness of patient shown in B. In plague following the use of a biological weapon, presence of cervical bubo is rare; purpuric skin lesions and necrotic digits occur only in advanced disease and would not be helpful in diagnosing the disease in the early stages of illness when antibiotic treatment can be lifesaving. Figures from Centers for Disease Control and Prevention, Division of Vector-Borne Infectious Diseases, Fort Collins, Colo.